Wiltshire College
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Accommodation at Wiltshire College

Successful completion of this application does not guarantee the applicant a room. The Accommodation Team will contact applicants with further instructions in due course.

Mandatory = *  
Title * Mr Miss Ms Mrs
First Name *
Surname *
Known as
Home Phone *
Mobile Phone *
Email *
House name/number*
Street name
Area
Town *
County *
Postcode/Zipcode *
Country *
Male/Female * Male Female
DOB * (dd/mm/yyyy)

I am quiet sociable lively *
First Language *
Place of Birth *

Are you 'ordinarily resident' in the UK or EU? * Yes No


Ethnicity *

Asian or Asian British   Mixed  
Bangladeshi White and Asian
Indian White and Black African
Pakistani White and Black Caribbean
other Asian background other Mixed background
Chinese    
Black or Black British   White  
African British
Caribbean Irish
other Black background other White background
       
any other prefer not to say

Allergies (please state)

Disabilities  

I am a wheelchair user or have mobility difficulties

I have an unseen disability e.g. epilepsy, diabetes or asthma
I have a disability or special need not listed above (please give details below)
 

Your Course Details *

Enter your course title
Lackham Campus

Additional Information

Please describe yourself, your interests and hobbies. This data will be collected in confidence and will enable us to allocate you the best room for your needs.



characters left


Do you require a disabled parking space?   Yes No

You should be aware that there are no reserved parking spaces for residents. There are 5 parking spaces for students with a blue badge but these are not specifically reserved for individual students.

Before submitting this form, please type the characters displayed above:

Successful completion of this application does not guarantee the applicant a room.

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